Shopfront Improvement Grant Phase 2 - Application Form

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* 1. Name of Business

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* 2. Applicant Details

Title

First Name

Middle Name/s

Surname

Landline Phone Number

Mobile Number

Email Address

Confirm Email Address

Alternative Contact Mobile Number

Business/Organisation Details

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* 3. Job Title/Position/Role in the Business/Organisation.

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* 4. Business Address

Address

Address 2

City

Post Code

Email Address

Phone Number

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* 5. Contact Address (if different than above)

Address

Address 2

City

Post Code

Email Address

Phone Number

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* 6. Status of Organisation (sole trader, partnership, limited company, limited liability partnership, company limited by

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* 7. d) Business address if different than above

Number

Street

City

Post Code

Email Address

Phone Number

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* 8. Company registration number (if applicable)

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* 9. Charity registration number (if applicable)

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* 10. VAT Registration number (if applicable)

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* 11. Are you (the Applicant) or your business linked with any other businesses, or is your business a subsidiary of a larger organisation?

Yes

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* 12. If ‘Yes’ please provide details of the linked business(es). Refer to the Application Guidance page 4 ‘Business and Organisation Details’ for a definition of ‘linked business’

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* 13. Will the project take place in rented / leased / tenanted premises?

Rented by your business

Owned by your business

Tenanted by another business

Other (please specify)

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* 14. Have either you or your business received support from other external grant sources in the last 3 years? If so please provide details here.

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* 15. Have any of the business principals been:

Disqualified as director

Listed on the individual insolvency register

Subject to bankruptcy proceedings

Subject to a county court judgement

None of the above

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* 16. If you answered ‘yes’ to any part of this question, please provide details below.

Shop Front Plan Overview

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* 17. In less than 500 words, please provide a short description of what you would like to do to improve your shopfront

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* 18. Please confirm that you have read the Shop Front Improvement Grant Scheme Information Pack Shopfront Design Guide and believe that your project adheres to the guidance

Yes

Project Delivery Overview

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* 19. Please give a brief description of your business and what it does. Also, please give a brief description of the premises where you would like to undertake the project, including the issues that your project is looking to tackle.

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* 20. Who will be responsible for managing the project?

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* 21. What skills and experience do they have for doing this? - including delivering the physical works of the project and managing the funding claims

Project Timescales

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* 22. Proposed Project Start Date

Date / Time

Date

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* 23. Expected Project Completion Date

Date / Time

Date

Project Costs

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* 24. Total Project Cost (net of VAT unless VAT is non-recoverable)

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* 25. Funding Amount Requested From Grant (minimum of £500 up to a maximum of £3,500)

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* 26. Match funding amount from your business (must be at least 15% of total project cost)

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* 27. Please tell us where the match funding will be coming from (e.g. own funds, bank loan etc).

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* 28. Please confirm that match funding is in place before project start (tick).

Please note that if match funding is not in place, any funding offer made will be conditional upon receiving it.

Yes

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* 29. If your preferred supplier for any of the costs is not the cheapest quote, please explain your reasons for the choice of supplier.

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* 30. g) Are either you or the business applying for the grant connected with any of the businesses providing quotes on the project costs? If yes, please identify who and how they are connected?

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* 31. Project Impact
Please explain and describe any additional benefits, outcomes and outputs that your project will provide to Colchester City Centre

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* 32. Permissions
a) Do you require Planning Permission for this project?
You MUST contact Simon.Cairns@colchester.gov.uk to check

Yes

Other (please specify)

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* 33. b) If Planning Permission is required, has it been granted? If so, please provide details:
Planning Reference Number and date of the decision

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* 34. Declarations

WARNING
The Government, Council and Our Colchester BID will not accept deliberate manipulation and fraud and any applicant caught falsifying their records to gain grant money will face prosecution and any funding issued will be subject to claw back, as may any grants paid in error.

By submitting and/or agreeing to the submission of this application form I agree to the following declaration:

I confirm that, to the best of my knowledge and belief, all of the information contained in this application is true and correct and I accept full responsibility for it. I understand that, should this application be successful, I will be required to supply additional information. If there is any change to the information I have provided, I will notify Our Colchester BID without delay.

I am aware of the conditions that apply to this application and have complied with them. I declare that I have read, understood and complied with all of the relevant guidance information relating to the Our Colchester BID Shopfront Enhancement Scheme.

I understand that my business may be inspected and I agree to give access, cooperate and provide such assistance as is required. I understand that I give Our Colchester BID the authority to investigate any part of the project with the contractors.

I confirm that I have disclosed details of all business interests held by any members of this business. I have declared details of any thing or person connected with my business (including employees) and this grant application that may impact on or cause a conflict between my business and any part of this grant application.

I understand that if my application is successful, I will be required to enter into a grant funding agreement, and payment of any grant funding will be conditional on compliance with the terms of that agreement. I understand that use of an agent will not limit my responsibility to comply with the terms of that agreement, nor does it affect my personal responsibility to ensure the accuracy of the information provided in this application.

Important Information

You should not commence project activity, or enter in to any legal contracts, including the ordering or purchasing of any equipment or services, before your application has been formally approved and you have entered into a grant funding agreement. Any expenditure incurred before the approval date is at your own risk and may render the project ineligible for support.

If you knowingly or recklessly make a false statement to obtain grant aid for yourself or anyone else you risk prosecution, the recovery of all grant payments and exclusion from other schemes operated by CCC and Our Colchester BID. By submitting this form you are confirming that you have read and agree with the above declarations and you consent to us processing the information that we collect from you.

Signed for and on behalf of the Applicant. All partners / directors of an applicant business must sign the application below.

Yes - I agree

No - I do not agree

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* 35. Bank Details

Bank Name

Address inc postcode

Account Name

Account Number

Sort code

Appropriate Consents and Permissions

Where applicable, please submit the following documents with your application. Please note that we will not return any documents submitted with your application.